Triple Negative Breast Cancer: A Brief Review of its Characteristics and Treatment Options

Abstract

Triple negative breast cancer (TNBC), an aggressive variant of breast cancer, is characterized by lack of expression of the estrogen (ER) and progesterone receptors (PRs) and the human epidermal growth factor receptor (HER-2) that are commonly observed in other breast cancer subtypes. The TNBC subtype primarily occurs in younger women of African American or Hispanic descent and tumors tend to be high grade and initially responsive to chemotherapy. However, TNBC is characteristically aggressive with high recurrence, metastatic, and mortality rates. Treatment options are limited since the hormonal receptor and HER-2 antagonists typically used for other breast cancers are ineffective. As such, the mainstay of treatment of TNBC is traditional systemic cytotoxic chemotherapy. Potential future therapies for TNBC include targeted molecular strategies including poly (adenosine diphosphate ribose) polymerase (PARP) and epidermal growth factor receptor (EGFR) inhibitors and antiangiogenic agents. Further research aimed at identifying unique genetic characteristics of TNBC may allow development of other targeted molecular chemotherapy treatment options.

Preclinical Evaluation of Fatty Acid Synthase and EGFR Inhibition in Triple-Negative Breast Cancer

“…TNBC lacks an approved targeted therapy, and it is mainly treated with a combination of anthracyclines and taxanes (25). The high rate of relapse after treatment urges for the development of new targeted therapies for these patients.…”

Targeting multiple tyrosine kinase receptors with Dovitinib blocks invasion and the interaction between tumor cells and cancer-associated fibroblasts in breast cancer

“…Treatment options are very limited except with the traditional cytotoxic chemotherapy. 1 The systematic evaluation of different randomized clinical trials indicated that combining targeted agents with chemotherapy in triple negative breast cancer produced only modest gains in progression-free survival. 2 Therefore, a better understanding of the molecular basis of breast cancer progression and development of novel molecular targeted therapy is required for the better treatment of this breast cancer subtype.…”

Cultural and Environmental Factors of Triple-Negative Breast Carcinomas

“…Specifically, African American women have a higher incidence of triple-negative breast cancer than White Americans [7][8][9][10][11]. Triple-negative breast cancer is one of five subtypes of breast cancer which have been recognized to be luminal A (ER+ or PR+, HER2 -), luminal B (ER+ or PR+, HER2 +), HER2-overexpressing (ER-, PR-, HER-2+), basal-like (ER-, PR-, HER-2-, cytokeratin 5/6 + or epidermal growth factor receptor +), and unclassified or normal tumors [10][11][12].…”

“…It is important to note that "basal-like" and "triple-negative" are not exactly synonymous (though they oftentimes overlap), as basal-like refers primarily to tumors defined by gene expression markers (including cytokeratins), whereas triple-negative is defined as having ER-, PR-, and HER2-status [7,9]. The triple-negative subtype is commonly referred to in the literature and will be the primary focus of this review.…”